Background: Palatal rugae are asymmetric and irregular ridges on the anterior palatal region, which have proven to be useful in the field of forensic dentistry. This study aims to use morphological analysis of palatal rugae patterns to assess sex in a South Indian adult population. Materials and Methods: This cross-sectional study was undertaken to evaluate a total of 300 maxillary dental casts (150 males and 150 females). The rugae patterns were marked by one observer and classified as per Thomas and Kotze criteria by another observer. The rugae patterns were classified based on the total number of rugae, shape, predominant direction of rugae, and unification of rugae. Results: The palatal rugae in female participants showed a higher incidence of circular rugae and backward directed rugae, while male participants showed more forward-directed rugae. The logistic regression analysis showed a significant association of with circular (OR=1.48; 95% CI= 1.02-2.13), forward (OR=0.87; 95% CI= 0.78-0.97) and backward (OR=1.23; 95% CI= 1.08-1.41) palatal rugae with sex. Conclusion: Certain palatal rugae patterns can be used for the assessment of sex with limited accuracy.
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